This invention relates generally to medical devices and more particularly to devices for use with intra-lumen catheters or guide wires therefore.
Many medical diagnostic and treatment techniques involve the use of a catheter for introduction into a passageway, e.g., a blood vessel, in the patients body. In order to locate the catheter in a small remotely located distal branch vessel the catheter itself or a guide wire for a catheter has to be inserted into the body and guided through various small compound curves and branches. In the case of a guide wire, once the guide wire is in place the catheter is then slid down the guide wire to the desired location, and the guide wire removed or left in place, as the case may be.
One prior art technique for effectuating the placement of a catheter or guide wire (hereinafter referred to as catheter/guide wire) at a remotely located position within a blood vessel involves the use of a steerable catheter/guide wire having a curved or curvable distal end or tip. That device is then fed from its percutaneous introduction site, e.g., the femoral artery, down the artery or vein while its movement is observed by means of a fluoroscope or other suitable scanning device. When the catheter/guide wire reaches a branch the catheter/guide wire is manipulated by applying rotary torque to it. Such torque is applied at a point proximally from the percutaneous introduction site and results in the rotation of the catheter/guide wire about its longitudinal axis. The rotary torque is applied until the catheter/guide wire is rotated to the position at which its curved distal end is pointed in the desired vascular branch direction. The catheter/guide wire can then be fed further into (distally) the vessel. This procedure continues and is repeated until the distal end of the catheter/guide wire is located at the desired intravascular location.
Examples of prior art steerable catheters/guide wires are shown in U.S. Pat. Nos. 3,521,620 (Cook), 3,547,103 (Cook), and 4,020,829 (Wilson et al.).
Some prior art steerable catheters/guide wires make use of a controllably curvable tip. For example, one type of steerable tip catheter involves the use of plural control wires extending the length of the catheter from its tip to some proximally located steering device. The steering device operates the various control wires to bend the tip in the desired direction. Another type of steerable tip catheter involves the use of singular fluid pressure means in combination with restraining means to bend the catheter from a straight orientation to a predetermined curved orientation extending in a predetermined direction. The use of plural fluid pressure means in lieu of a single fluid pressure means enables the tip to be bent into a curved orientation extending in any one of several directions. Examples of such steerable catheters are shown in U.S. Pat. Nos. 3,625,200 (Muller) and 3,773,034 (Burns et al.).
While the foregoing prior art catheters appear generally suitable for their intended purposes they leave much to be desired from the standpoint of simplicity of construction and use. Moreover the steering means for such catheters, by being built into the catheter thus prevents its use with other types of catheters and/or guide wires. Thus, the need exists for a device which can be used with conventional catheters/guide wires or other elongated flexible shaft instruments to effect the selective gripping and longitudinal and/or rotational movement thereof.
With regard to the need for effecting the selective rotation of a shaft, it will, of course, be appreciated by those skilled in the art that various chuck-type devices have been disclosed in the literature for gripping the periphery of a rigid shaft to rotate the shaft about its longitudinal axis. For example U.S. Pat. No. 3,908,487 (Plaw) discloses a screwdriver having a handle including a plurality of rollers disposed about the shaft of the screwdriver and which are arranged to selectively roll along a lobed sleeve to move the rollers into tight engagement with the shaft so that the shaft will rotate when the handle of the screwdriver is rotated. U.S. Pat. No. 973,345 (Dalton) discloses a drill chuck which is constructed and which operates in a similar manner to the screwdriver of the Plaw patent.
While the foregoing prior art chuck type devices are generally suitable for their intended purposes, i.e., to effect rotation of a rigid shaft, they do not enable the positioning of the same along the shaft to any desired position. Moreover such devices do not appear suitable for use with a flexible shaft medical instrument of small outside diameter, such as a catheter/guide wire, to effect the rotation thereof from a point outside the body.